The goal of this clinical trial is to compare different mechanical ventilation settings in Patients undergoing laparoscopic surgery and affected by Expiratory flow limitation. The main question\[s\] it aims to answer are: * If individualizing mechanical ventilation on expiratory flow limitation can reduce pulmonary postoperative complications; * If patients with expiratory flow limitation have a higher incidence of pulmonary postoperative complications as compared to patients with no expiratory flow limitation; Participants will be screened for expiratory fow limitation and patients with positive screening will be randomized into two groups. Each group will receive a different intraoperative mechanical ventilation: * Personalized positive end-expiratory pressure based on EFL * Standard of care positive end-expiratory pressure Researchers will then compare the two groups to see if the incidence of pulmonary postoperative complications in the first 7 days after surgery is different.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
1,536
Positive End expiratory pressure will be set according to the positive end-expiratory pressure able to revert the expiratory flow limitation.
Positive End expiratory pressure will be set not according to the positive end-expiratory pressure able to revert the expiratory flow limitation but to a standard level of 4 cmH2O.
Postoperative pulmonary complications
The investigators will evaluate the number of Pulmonary postoperative complications in the first 7 days after surgery
Time frame: First 7 days after surgery
Postoperative Oxygenation
The investigators will evaluate postoperative oxygenation after surgery
Time frame: Within 2 hours after surgery
Need for intubation or non-invasive ventilation
The investigators will evaluate the need for intubation or non-invasive ventilation
Time frame: First 7 days after surgery
Days of hospitalization
The investigators will evaluate the number of days of hospital stay
Time frame: From hospital entrance to hospital discharge, assessed up to 30 days
Need for Intensive Care admission
The investigators will evaluate the need for Intensive Care admission
Time frame: From hospital entrance to hospital discharge, assessed up to 30 days
Length of stay in ICU
The investigators will evaluate the length of Intensive care unit stay
Time frame: From intensive care entrance to intensive care discharge, assessed up to 30 days
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